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Page 2 - Clinical Connections - Spring 2017.indd
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RVC RESEARCH  STUDY  VETERINARYSERVICES  RVC.AC.UK
can have a much better quality of life as well as a longer life.
“Not only can we offer a better quality of life for the dogs, as it improves their ability to exercise, we can also offer a better quality of life for owners. Owners of dogs with mitral valve disease often have had to change their lifestyle to make sure they can give the dog the medication it requires at the necessary time intervals. Therefore, if we can reduce the number
of medications and the frequency of medications that these animals receive, then the owners really benefit as well.”
Alluding to the surgical challenges,
all, in fact they form blood clots on them very quickly.
“Therefore we repair the valve, using a combination of techniques – some of which replace the suspensory apparatus (chordae tendinee) of the valve with some Gore-Tex suture material. The other component is to place an annuloplasty to bring the enlarged valve annulus down to a normal size so the valve leaflets can meet properly.”
Although the RVC team has, inevitably, operated on the most severely affected animals, the evidence from human medicine shows that the earlier you intervene the better the long-term
“Performing a repair of the mitral valve is not a straightforward thing.There’s a very steep learning curve
and each patient is slightly different.”
Above: Cardiothoracic surgery patient Dave cardiology aspects, the advanced surgical
aspects and the critical care components of the care these animals need, which will develop key transferable clinical skills.
Vets can refer dogs with mitral
valve disease by either contacting the cardiology service or Dan Brockman or Poppy Bristow in the surgery team, via the referrals line (01707 666365).
In the near future we will be making a dedicated link for enquiries available through our website.
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rvc.ac.uk/clinical-connections
Professor Brockman added: “These
are some of the most interesting but
also challenging patients to operate on. We steered clear of mitral valve disease surgical patients until we had the fundamentals of cardio-pulmonary bypass under control. Performing a repair of
the mitral valve is not a straightforward thing.There’s a very steep learning curve and each patient is slightly different. Simplistically, taking a diseased valve out and replacing it with an artificial valve that we know works perfectly well would be a much easier thing to do than attempting to repair a valve.The problem is that dogs don’t tolerate artificial valves very well at
outcome.The RVC team anticipates that, over time, the patient population will shift from being dogs with end-stage disease
to those that have not had a bout of failure but are known to have bad valves. Therefore valves can be repaired before many of the secondary degenerative cardiopulmonary events have happened.
The educational benefit of expanding the RVC’s mitral valve programme is many fold. Undergraduate students
will see more dogs with mitral valve disease and, as a result, will gain a better understanding of how to treat it medically. In terms of postgraduate clinical training, scholars will be exposed to the advanced
LETTER FROM THE EDITOR
As a leading veterinary
teaching establishment, a significant part of our remit is to ad- vance knowledge and skills in clinical practice, which not only means train- ing our students to become the vet- erinary professionals and specialists of the future, but also extracting the potential learning value from every clinical case we see, and sharing the benefits.
The reports in this issue of
Clinical Connections illustrate how
that sharing of knowledge occurs both within and beyond the College, through our interaction and partnership
with colleagues both in practice and in other veterinary institutions around the world.Whether it’s through clinical rounds and case reviews, CPD and its publications, collaborative research or sharing our thoughts with
referring vets, our aim is to make a positive difference, every day.
We believe that the best referral is one in which we work closely with our referring partners to combine our collective clinical expertise and the best evidence available, to provide our patients and their owners with the care and consideration appropriate to their individual circumstances.
Although we may not achieve perfection every time, I hope you can identify with this philosophy and will
continue to team up with colleagues at the RVC and see us as an extension of your practice.Thank you for being such a significant part of ours!
Graham Milligan,
Vice Principal (Clinical Services)
02 Spring 2017


































































































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